Case 19-2014: A 19-Year-Old Woman with Headache, Fever, Stiff Neck, and Mental-Status Changes

A 19-year-old woman was admitted to the pediatric ICU because of a headache, fever, photophobia, neck stiffness, and mental-status changes. She was drowsy and disoriented with respect to year. She had truncal ataxia and rotatory nystagmus, and her face and right arm were numb. Presentation of Case Dr. Robin M. Jones (Neurology): A 19-year-old woman was admitted to the pediatric intensive care unit of this hospital in the autumn because of headache, fever, photophobia, neck stiffness, and mental-status changes. The patient had been well until 7 days before admission, when headache and nausea developed. She was seen at the emergency department of a hospital in Massachusetts 6 days before admission. The physical examination and laboratory test results were normal. Intravenous fluids and ketorolac were administered, with improvement. A diagnosis of tension or migraine headache was made, and she returned to her college dormitory. Two . . .